Respiratory Physiology

heart

circuitry

heart circuitry tissues

lung heart circuitry tissues

lung heart circuitry tissues cell

STRUCTURE of respiratory system - Conducting zone - Respiratory zone

STRUCTURE of respiratory system - Conducting zone (nose, larynx, trachea, bronchi, bronchioles) The walls conducting airways contain smooth muscle -Sympathetic -Parasympathetic -  2 receptors relaxation, dilatation of the airway

STRUCTURE of respiratory system - Conducting zone Anatomic dead space -V of the conducting airways Physiologic dead space -V of the lungs that does not participapate in gas exchance

STRUCTURE of respiratory system - Conducting zone Physiologic dead space (VD) -V of the lungs that does not participapate in gas exchance Pa CO2 – PE CO2 VD = VT x Pa CO2 VT – tidal volume Pa CO2 – P CO2 of arterial blood PE CO2 – P CO2 of mixed expired air

STRUCTURE of respiratory system Respiratory zone Alveoli Lung ~ 300 x 10 6 alveoli

diaphragm inspiration expiration

inspiration – mm. intercosales externi

expiration – mm. intercosteles interni

inspiration – mm. intercosales externi expiration – mm. intercosteles interni

inspiration – mm. intercosales externi expiration – mm. intercosteles interni

inspiration – mm. intercosales externi expiration – mm. intercosteles interni

inspiration – mm. intercosales externi expiration – mm. intercosteles interni

inspiration – mm. intercosales externi expiration – mm. intercosteles interni

inspiration – mm. intercosales externi expiration – mm. intercosteles interni

diaphragm inspiration expiration pleura parietalis

diaphragm inspiration expiration pleura visceralis

diaphragm inspiration expiration pleura parietalis pleura visceralis transmural pressure

diaphragm inspiration expiration pleura parietalis pleura visceralis transpulmonal pressure

diaphragm inspiration expiration pleura parietalis pleura visceralis intrapulmonal pressure

diaphragm inspiration expiration pleura parietalis pleura visceralis transmural pressure transpulmonal p. intrapulmonal pressure

diaphragm inspiration expiration pleura parietalis pleura visceralis transpulmonal p.

bránice - diaphragma inspirace expirace pleura parietalis pleura visceralis transmural p. PNEUMOTHORAX

diaphragm inspiration expiration pleura parietalis pleura visceralis transmural p. transpulmonal p. intrapulmonal pressure alveoli

ventilation V

Physiologic dead space Is the volume of air in the lungs that does not participate in gas exchance (i.e.e it is dead) Anatomic dead space – is the volume of conducting airways Functional dead space volume – which is made up of alveoli that do not participate in gas exchance (alveoli that are ventilated, but are not perfused by pulmonary capilary blood)

Physiologic dead space P aCO2 – P ECO2 V D =V T x P aCO2 V D – physiologic dead space (mL) V T – tidal volume (mL) P aCO2 – P CO2 of arterial blood (mmHg) P ECO2 - P CO2 of expered air (mmHg)

Physiologic dead space P aCO2 – P ECO2 V D =V T x P aCO V D = 500 x =500 x 0.25 =125

Alveolar ventilation V A = (V T – V D ) x breasths/min V A - alveolar ventilation (mL/min) VT- tidal volume (mL) VD- physiologic dead space (mL/min)

Alveolar ventilation V A = (V T – V D ) x breasths/min V A = (500 – 125) x 16 = 375 x 16 = 6000 mL/min

lung heart circuitry tissues cell

diffusion

perfusion

ventilation diffusion perfusion

ventilation - static volums - dynamic volums

STATIC VOLUMS

1 s FEV 1 VC V t DYNAMIC VOLUMS FEV x 100 VC > 80 % Physiological value:

1 s FEV 1 VC V t DYNAMIC VOLUMS OBSTRUCTION  FEV1 = VC Restriction  VC = FEV1

Infection inhaled allergens inhaled irritants food allergens inducing stimuli mental stress medicines Triggers

respiratory irritant factors physical activity preventing infection sick people, vaccination, intensive treatment sufficient fluid intake eat small portions breathing exercises

Differential diagnosis

steroid potentiation of beta-adrenergic receptor bronchospasmolytic effect cholinergic antagonism reduction in mucus production - anti-inflammatory effect - block the formation of antibodies - stabilization of lysosomes block - formation and release of histamine

1 s FEV 1 VC V t DYNAMIC VOLUMS RESTRICTION = FEV1  VC

difusion alveolo-capillary membrane (surfactant)

difusion alveolo-capillar membrane (surfactant)

perfusion (heart)

Pulmonary edema - cardiogenic - noncardiogenic

Cyanosis (right ventricle)

Causes of cyanosis Central cyanosis Decreased arterial saturation Hemoglobin abnormalities Peripheral cyanosis Reduced cardiac output Cold exposure Redistribution of blood flow from extremities Arterial obstruction Venous obstruction

lung heart circuitry tissues cell

perfusion (anemia)

perfusion (emboli)

perfusion (emboli)

dg. pulmonal emboli

Dg. pulmonal emboli

% hemoglobin saturation 100 pO 2 Bohrs effects

% hemoglobin saturation 100 Bohrs effect – O 2 hemoglobin dissociation curve pO 2

% hemoglobin saturation 100 Shift to the right pO2

100 čas Shift to the right  temperature  pH  [H+]  2,3 - DPG % hemoglobin saturation pO2

100 Shift to the left  temperature  pH  [H+]  2,3 - DPG % hemoglobin saturation pO2

% hemoglobin saturation 100 Bohr effect pO2

pO 2 mmHgsaturation (%) Values of pO 2 and corresponding values of percent saturation of hemoglobin

lung heart circuitry tissues cell